Hypoxic damage and neovascularization of endometrium in endometrial hyperplasia

Abstract

E.A. Kazachkova, E.L. Kazachkov, A.V. Zatvornitskaya, E.E. Voropaeva South Ural State Medical University, Chelyabinsk, Russian Federation Aim: to assess the effects of hypoxic damage and neovascularization of endometrium in women with endometrial hyperplasia by analyzing endometrial expression of HIF-1α and CD34. Patients and Methods: 100 women were enrolled in the study. Group I included 30 women with endometrial hyperplasia (without atypia) and chronic endometritis. Group II included 30 women with endometrial hyperplasia without atypia. Group III included 20 women with chronic endometritis. Group IV (controls) included 20 healthy women. Endometrial specimens were collected on days 18–22 of the cycle with manual vacuum aspirator with the help of hysteroscopy guidance (groups I and II) or by pipelle biopsy (groups III and IV). Complex morphological study of endometrium was performed. The percentage of cell nuclei with immunopositive staining (at least in 1,000 cells per 10 view-fields) was calculated. To make HIF-1α and CD34 expression analysis more objective, computer-assisted morphometric image analyzer “Videotest-Morphology” v. 5.2 was applied. Kruskal-Wallis test was used to evaluate quantitative parameters. χ2 test with Yates’ continuity correction was used to compare qualitative parameters. Results: significant upregulation of HIF-1α and CD34 expression in the endometrium was demonstrated for endometrial hyperplasia and chronic endometritis as compared with isolated endometrial hyperplasia or chronic endometritis. Conclusion: significant upregulation of HIF-1α expression in endometrial hyperplasia and chronic endometritis demonstrates more severe hypoxic damage of the endometrium as compared with isolated endometrial hyperplasia or chronic endometritis. Significant upregulation of CD34 expression in endometrial hyperplasia and chronic endometritis demonstrates more severe endometrial neovascularization. Keywords: uterus, endometrial hyperplasia, chronic endometritis, hypoxic damage, HIF-1α. For citation: Kazachkova E.A., Kazachkov E.L., Zatvornitskaya A.V., Voropaeva E.E. Hypoxic damage and neovascularization of endometrium in endometrial hyperplasia. Russian Journal of Woman and Child Health. 2019;2(3):232–235.